Comparison of Quantiferon-Tb Gold In-Tube (Qft-Git) and Tuberculin Skin Test (Tst) for Diagnosis of Latent Tuberculosis in Haemodialysis (Hd) Patients: A Meta-Analysis of Κ Estimates Publisher Pubmed



Ayubi E^{1, 2, 3} ; Doostiirani A⁴ ; Sanjari Moghaddam A⁵ ; Khazaei S^{2, 4} ; Mansori K^{6, 7} ; Safiri S⁸ ; Sani M⁹ ; Mostafavi E^{3, 10}
Source: Epidemiology and Infection Published:2017

Abstract

Diagnosis of latent tuberculosis infection (LTBI) is a concern in haemodialysis (HD) patients. Many studies have compared QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) for detecting LTBI and reported the κ statistic of agreement between QFT-GIT and TST in HD patients. The present study aimed to systematically review this literature and conduct meta-analysis of individual studies that estimated the κ between QFT-GIT with TST among HD patients. All relevant published studies that were available as full-text were obtained by searching Medline (1950), Web of Sciences (1945), Scopus (1973) through May 2016. The κ was re-estimated from the individual studies and pooled using random effect meta-analysis. Subgroup analysis and meta-regression were applied to evaluate the effect of Bacillus Calmette-Guerin (BCG) vaccination, TST cut-off points, quality of studies, sample size and age on variation of κ estimate. Eight studies involving 901 HD patients were included in meta-analysis. The pooled κ estimate was 0·28 (I 2 = 18·4%, P = 0·239, 95% confidence intervals 0·22-0·34). The discordance of TST-/QFT-GIT+ was more than TST+/QFT-GIT-. History of BCG vaccination, TST cut-off points and age are related to variation of κ estimates. TST and QFT-GIT are not comparable in detecting LTBI in HD patients. The higher TST-/QFT-GIT+ ratio compared with TST+/QFT-GIT- ratio, may indicate the superiority of QFT-GIT over TST for detection LTBI in HD patients. © Copyright 2017 Cambridge University Press.